Motivated by the health benefits of a plant-based diet, Carly Minsky, then in his mid-20s, saw cutting out meat and fish as a natural and desirable step.
At first, she felt “great,” she says, as she enthusiastically committed herself to her new regime. After a year, however, it was a completely different story.
“I started to feel very tired,” recalls Carly. “It wasn’t just fatigue, it was extreme fatigue.” She also gained weight.
“I went on like that for six years, not sure what was going on, and in 2020 I could barely walk because I was so exhausted,” says the journalist, 33, from London.
Finally, concerned that it could be a problem with her thyroid (which produces hormones to regulate metabolism), she went to her GP in 2021, who sent her for blood tests.
Motivated by the health benefits of a plant-based diet, Carly Minsky, then in his mid-20s, saw cutting out meat and fish as a natural and desirable step. At first, she felt “great,” she says, as she enthusiastically committed herself to her new regime. But after a year it was a completely different story
Within days, Carly was called back to the operating room and told her that her vitamin B12 levels had dropped so dramatically that she would need emergency vitamin B12 injections every other day for the next six weeks, then potent vitamin B12 every day for her life. tablets. Cause? Her diet.
Vitamin B12 is mainly found in animal and dairy products – meat, fish, eggs, milk and cheese, for example – and is vital for many important bodily functions, including brain health and red blood cell production.
Deficiency can lead to health problems, including anemia (low iron levels in the blood), fatigue, palpitations, shortness of breath, nerve problems and psychological problems.
Those over age 60, who are more likely to have nutritional deficiencies, and those with pernicious anemia, an autoimmune disease that means the body can’t absorb B12 properly, are at risk. So also vegans.
Earlier this year, the National Institute for Health and Care Excellence (NICE) reported that 6 percent of the population under the age of 60 has a B12 deficiency, rising to 11 percent among vegans.
Although Carly still ate cheese and eggs and drank milk, during those years of vegetarianism, her intake was not enough and her vitamin B12 levels had dropped.
“My GP said I was on the dangerously low end of the scale and needed immediate B12 injections,” she says. “It was a huge shock. I had no idea I would become so unwell.
‘It took two months with injections before I started to feel better, and of course I still take vitamin B12 tablets daily.’
Most people get enough B12 from their diet – the recommended intake is 1.5 micrograms per day (an average diet of chicken, fish, beef and eggs will give you enough).
“But some people — including those on restrictive diets who don’t consume animal products, or who eat a poor diet rich in processed foods — don’t get enough vitamin B12,” said Sue Pavord, a hematologist consultant at Oxford University Hospitals and vice president of the British Society for Hematology.
Vitamin B12 is found mainly in animal and dairy products – meat, fish, eggs, milk and cheese, for example – and is vital for many important bodily functions, including brain health and red blood cell production.
She says B12 deficiency is a severely neglected area of public health, affecting 10 percent of people over 60.
‘The human body cannot make B12 and therefore needs it from the diet,’ she explains. Early symptoms of deficiency can be vague, such as fatigue or symptoms of anemia — palpitations, shortness of breath and exhaustion.
“But as the deficiency progresses, neurological symptoms can develop, such as tingling in the fingers and toes, or loss of balance.”
This is because B12 is vital for the maintenance and formation of protective sheaths that cover nerves, ensuring rapid and effective transmission of messages, explains Dr Moez Dungarwalla, a hematologist consultant at Milton Keynes University Hospital, from.
‘A fatty substance called myelin is essential for the formation of these sheaths, and vitamin B12 plays an important role in the synthesis and maintenance of myelin,’ he explains. “The neurological problems caused by B12 deficiency are in part due to damage to the myelin sheath.”
In extreme cases, vitamin B12 deficiency has been linked to macular degeneration (which can lead to vision loss), heart disease, cognitive impairment, dementia, stroke and psychosis.
However, the vague — or lack of — early symptoms may mean some people don’t know they’re suffering from a potentially serious deficiency, as former consultant Stephen Wright found.
The 70-year-old from Dorset only found out two years ago during a GP check that he had a B12 deficiency. Routine blood tests revealed that he had a severe vitamin deficiency and that he would need injections every six weeks for life to prevent neurological disorders from developing.
Doctors think his deficiency was due to his age and unhealthy diet.
Some pre-existing conditions can also lead to a deficiency — the most common being pernicious anemia, says David Smith, professor emeritus of pharmacology at the University of Oxford.
“Pernicious anemia affects one in 1,000, and up to one in 500 in people over 60,” he says. ‘It’s an autoimmune disease with family ties. It is not known what causes it, but it prevents the absorption of vitamin B12 in the gut.’
Other diseases that hinder the absorption of B12 include reduced acid secretion in the stomach (again common with aging) and Crohn’s disease and celiac disease.
Some medicines interfere with the absorption of vitamin B12, including metformin (used to treat diabetes) and proton pump inhibitors such as omeprazole (for acid reflux).
The good news is that the symptoms can be reversed for most patients.
Professor Smith explains: ‘Most people will be able to correct their low vitamin B12 status by taking tablets, and a good starting dose is 1 microgram per day. Many patients with pernicious anemia require injections.’
But people often don’t realize they’re deficient until damage has been done.
‘If a person does not receive treatment, irreversible changes in the neurological system can occur,’ says Dr Pavord. “That also includes difficulty walking due to weakness; loss of balance and feeling; and disturbed vision.’
In addition to having B12 shots, Stephen took a low-carb regimen, lost three stones and feels much more energetic. “I had no idea how important vitamin B12 was until I went through it,” he says.
Carly’s symptoms resolved within two months of starting vitamin B12 treatment. “It was like my energy was turned back on,” she says.
The tattoos are used for medical purposes. This week: To check colon polyps
Tattooing is a technique doctors use in people’s colons to check for and remove lesions — based on commercially available dark inks.
However, these diffuse quickly, making it more difficult to identify a lesion, and leakage can lead to abscesses. Using ‘biomedical’ ink offers a safer alternative, according to research presented at the American Chemical Society conference.
The ink uses tiny metal-derived particles that provide the dark color needed to be seen under the light of a colonoscopy. It also spreads much less than commercial inks.